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24901 Santa Clara St # B2 Hayward CA 94544-2147 | |
| (510) 887-6835 | |
| (510) 887-2872 |
| Full Name | |
|---|---|
| Speciality | Dentist |
| Location | 24901 Santa Clara St # B2, Hayward, California |
| Authorized Official Name and Position | Jaime V Evangelista (DENTIST) |
| Authorized Official Contact | 5108876835 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
24901 Santa Clara St # B2 Hayward CA 94544-2147 Ph: (510) 887-6835 | 24901 Santa Clara St # B2 Hayward CA 94544-2147 Ph: (510) 887-6835 |
| NPI Number | 1215396809 |
|---|---|
| Provider Enumeration Date | 02/11/2016 |
| Last Update Date | 02/11/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215396809 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 37103 (California) | Primary |
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